Title Page
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Inspection Date / Time
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Contract / Job Number
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Inspection conducted by - State your name
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Area Manager
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Supervisor
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Workplace Location
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Additional location details - e.g. Junction No. Northbound carriageway
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Weather Conditions
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Type of Works (screed, spray, etc.)
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Vehicle Registration - List all present and inspected
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Crew (state names in full)
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Toolbox Talk delivered
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Toolbox Title
Operatives QHSE Mental Health & Wellbeing Comments and Feedback
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Any comments or feedback provided by Site Operatives regarding general wellbeing or welfare
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Are there any items that require immediate notification to the QHSE Manager
Core Elements - NOTE: Any 'fail' MUST be commented on in the 'comments' section
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Daily vehicle checks completed and recorded
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Stop work if incomplete and rectify
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Point Of Work Risk Assessment complete and recorded on the tablet
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Stop work if incomplete and rectify
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Traffic Management in place where required
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Is the work being undertaken in accordance with the stated RAMS?
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Stop work if not complied with and rectify
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Any additional comments
Site Management including Quality Management
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Wilson & Scott works pack available - Job Specification, RAMS, COSHH, Contract Information Sheet, Drawings
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Details of the applicable RAMS and random sample of applicable COSHH data safety sheet (state RAMS number)
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Emergency preparedness in place - extinguisher, eye wash, burns kit, first aid, procedure - Provide photos
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Provide evidence of site personnel competencies - CSCS, NHSS 12D - Card numbers or photos are required
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Housekeeping arrangements in place - materials and tools in tidy order, vehicle cab clean and tidy etc.
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Stop work if further action required and rectify
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Who is the competent First Aider on site?
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Any additional comments
Safety Clothing - PPE and RPE
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Is the correct PPE being worn (BS EN471) during operational activities - head, ear, eye, face, foot, hand, body
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Is the PPE clean and in good condition?
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Stop work if there are issues with the PPE and rectify
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If required, is dust / fume respiratory equipment worn (put N/A if not required)
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Stop work if not being worn and rectify
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Add any photo evidence to support this section
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Any additional comments
Materials
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Stacking, position, segregation and security
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Fuel storage and labelling - Are all jerry cans stored upright and secured in position?
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Minimisation of slip and trip hazards - i.e. on the bed of the truck
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Prevention of falling objects and security of load
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Are the correct materials being used in accordance with the job specification?
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Add any photo evidence to support this section
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Any additional comments
Plant, Fleet and Equipment
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Suitability and condition of the vehicle, Chapter 8 compliant - Vehicles newer than 2020 must have retroreflective red chevrons
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Do rear facing edges of doors and tailgates have red retroreflective stickers?
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Lifting equipment LOLER certified, inspection and operation
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Is access / egress from the vehicle safe with protection from slips and falls?
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Cleanliness of the vehicle, including signage
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Runlock / key out system in use at the time of the inspection?
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If not in use please explain further
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Add any photo evidence to support this section
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Any additional comments
Welfare Facilities
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Are there welfare facilities in place?
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Is there clean, fresh drinking water available and clearly labelled?
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COVID 19 Arrangements - Are there hand wipes, sanitiser, masks etc. available?
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Add any photo evidence to support this section
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Any additional comments
Environmental Considerations - Visual integrity of fuel systems
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Fuel
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Oil
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Hydraulic Oil
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Gas / Propane
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Are 'O' ring clamps present on gas hoses and secure? Jubilee clips are not compliant and must be referred to the workshop
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Spill kit available and full?
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What are the waste management procedures?
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Add any photo evidence to support this section
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Any additional comments
Additional Quality Elements
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Contract Information Sheet / written instructions provided to the crew
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Drawing / sketch available?
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Is the works process being undertaken included in the above documents
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Do the documents give a good description of the work to be done
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Does the work conform to the specified requirements
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Add any photo evidence to support this section
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Any additional comments
Inspection Completed By
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Name and position of person completing the inspection
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Inspected By Signature
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Date and Time
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Workplace Representative Name
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Workplace Representative Signature
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Date and Time
Inspection Summary
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Inspection Summary / Feedback - Brief description of outcome
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Is the report complete? Please check all mandatory fields have been completed and click on the 'complete report' button.
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Are there any items that require immediate notification to the QHSE Manager
